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There's no test for IBS, but you might need some tests to rule out other possible causes of your symptoms. The GP may arrange: a blood test to check for problems like coeliac disease. tests on a sample of your poo to check for infections and inflammatory bowel disease (IBD) Avoid IBS Trigger Foods. These include foods that are high in fat, caffeine, carbonation, alcohol, and insoluble Fiber, like: Soda and seltzer, Coffee, tea, soda, and chocolate.

Other symptoms of IBS • farting (flatulence) • passing mucus from your bottom. • tiredness and a lack of energy. • feeling sick (nausea) • backache. • problems peeing, like needing to pee often, sudden urges to pee, and feeling like you cannot fully empty your bladder. • not always being able to control when you poo (bowel incontinence) • How can I treat IBS myself? Drink plenty of fluid – at least 8 cups a day (but not all tea, coffee or fizzy drinks as these can worsen symptoms. Alcohol can also make symptoms worse). Water, sugar-free squash and herbal teas are good choices. Take regular exercise e.g. walking, cycling, swimming.

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterized by abdominal pain and discomfort, and can be experienced conjointly with altered bowel function and abdominal distention. There are four subtypes of IBS including IBS with diarrhoea (IBS-D), IBS with constipation (IBS-C), mixed IBS (IBS-M), and unsub typed IBS (IBS-U). Each subtype implicates unique symptoms, and each individual patient with IBS experiences symptoms differently, making effective treatment for IBS a complex task. Whereas pharmacologic methods are traditional ways of current treatment, alternative therapies are increasingly used among many patients, as prescription drugs aren’t highly effective. This literature review presents evidence for different types of conventional and alternative therapies and analyses the effectiveness of various trials conducted testing assorted treatments for patient with IBS. The literary evidence suggests that there is not one therapy or treatment that is most effective in treating IBS, but rather that all therapies need to be implemented in adjunction with others to be most effective and improve the wide range of symptoms experienced by patients. It is critical that providers understand this concept in order to provide the most effective treatments for patients that will not only relieve symptoms, but improve quality of life. Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterized by abdominal pain and discomfort, and can be experienced conjointly with altered bowel function and abdominal distention. There are four subtypes of IBS including IBS with diarrhoea (IBS-D), IBS with constipation (IBS-C), mixed IBS (IBS-M), and unsub typed IBS (IBS-U). Each subtype implicates unique symptoms, and each individual patient with IBS experiences symptoms differently, making effective treatment for IBS a complex task. Whereas pharmacologic methods are traditional ways of current treatment, alternative therapies are increasingly used among many patients, as prescription drugs aren’t highly effective. This literature review presents evidence for different types of conventional and alternative therapies and analyses the effectiveness of various trials conducted testing assorted treatments for patient with IBS. The literary evidence suggests that there is not one therapy or treatment that is most effective in treating IBS, but rather that all therapies need to be implemented in adjunction with others to be most effective and improve the wide range of symptoms experienced by patients. It is critical that providers understand this concept in order to provide the most effective treatments for patients that will not only relieve symptoms, but improve quality of life.

• Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterized by abdominal pain and discomfort, and can be experienced conjointly with altered bowel function and abdominal distention. There are four subtypes of IBS including IBS with diarrhoea (IBS-D), IBS with constipation (IBS-C), mixed IBS (IBS-M), and unsub typed IBS (IBS-U). Each subtype implicates unique symptoms, and each individual patient with IBS experiences symptoms differently, making effective treatment for IBS a complex task. Whereas pharmacologic methods are traditional ways of current treatment, alternative therapies are increasingly used among many patients, as prescription drugs aren’t highly effective. This literature review presents evidence for different types of conventional and alternative therapies and analyzes the effectiveness of various trials conducted testing assorted treatments for patient with IBS. The literary evidence suggests that there is not one therapy or treatment that is most effective in treating IBS, but rather that all therapies need to be implemented in adjunction with others to be most effective and improve the wide range of symptoms experienced by patients. It is critical that providers understand this concept in order to provide the most effective treatments for patients that will not only relieve symptoms, but improve quality of life. • between the amount of mast cell and luminal tryptase • level. Possible explanation for such fact is activation of • mast cells and tryptase secondary release are not • continuous process. Release of specific mediator • occurs gradually and tryptase release to the lumen will • increase only under certain circumstances. • 23 • Therefore, • it can be concluded that mast cell hyperplasia and tryptase • release is commonly occurred and they are important • findings in diarrhoea-predominant IBS patient who has • not received any treatment. Validity for both of them to • be biological marker of IBS and their potential benefit in • the management strategy of IBS should be studied • further.

CENTRAL DYSREGULATION • Psychosocial factor has been well-considered as • important factor in IBS pathogenesis. • 1 • Anxiety and • depression is commonly found in IBS patients • compared to normal population. • 1,3 • Some concepts • regard IBS as one of somatization disorder, but evidences • of organic pathophysiology had contravened the • concept. • 3 • There is a study that observed different brain • responses in IBS patient. • 29 • Measurement of regional brain • perfusion during rectal distension demonstrated that IBS • patients experienced greater activation of the anterior • cingulate cortex, amygdala nucleus and dorsomedial • frontal cortex in contrast either to the control subjects or • patients with ulcerative colitis. It is assumed that the brain • of individual without IBS has greater ability in activating • the inhibition area of endogen pain. This may be a • genetic predisposition. • 2 • Amitriptyline, an antidepressant, • has been proven to reduce rectal pain and correlates to • activation of dextran prefrontal cortex area, dextran incula, • and anterior cingulate cortex. • 30 • Such central process may • explain the potential benefit of antidepressant in IBS.

THE ROLE OF CORTICOTROPIN-RELEASING • HORMONE (CRH) IN PATHOGENESIS OF IBS • CRH is the main mediator of stress response in • brain-gut axis. In IBS, any disorder of such axis is • assumed to be related with over response against • stressor. • 31 • A study • 32 • showed that administration of • peripheral CRH would increase sensory and neural • function of visceral organ as such thing may also trigger • ACTH response in IBS patient. Electrical stimulation on • rectum significantly provided more trigger on colon • motility in IBS patients compared to the control. • Furthermore, the study evaluated the impact of giving • alpha-helical CRH, a non-selective CRH-receptors • antagonist, to IBS patients and control. After • administration of alpha-helical CRH, the colon motility • response was significantly reduced in IBS patients • compared to the control. Alpha-helical CRH reduced the • severity of abdominal pain and anxiety induced by • electrical stimulation in IBS patients. The plasma level • of ACTH and cortisol usually are not suppressed by • alpha-helical CRH. • An experiment in rats indicated that administration • of specific CRH-1 receptor antagonist apparently • inhibited sensitization of visceral perception induced by • colorectal distension. • 31 • There have been more evidences • developed supporting the concept that peripheral CRH